Denture characteristics, oral hygiene practice and periodontal changes of partial denture wearers and non-denture wearers in a Teaching Hospital- A comparative study

Background: There can be localized periodontal inflammation around abutment teeth of dentures as a result of plaque accumulation. This study assessed the periodontal changes of removable partial denture wearers compared to that of non-denture wearers. Methodology: Participants were recruited from the prosthodontic and restorative outpatient clinics of Lagos University Teaching Hospital. The self-administered questionnaire was used to collect information on socio-demographics, denture characteristics, periodontal changes and oral hygiene practice of participants. Periodontal status assessed included gingival inflammation, plaque accumulation and tooth mobility. Data was analyzed using SPSS version 20 (IBM SPSS Armonk, New York) and presented as frequencies and percentages. Test for significance was done using Chi-square statistics, and the level of statistical significance was set at P < 0.05. Results: A total of 96 participants between age 16 and 74years were recruited with mean age of 40±14.5years. There were 56 females and 40 males (F:M; 1.4:1). Fifty-four denture wearers and forty-two non-denture wearers were recruited into the study. Among participants wearing partial denture, 49(90.7%) had gingival inflammation; 45(91.8%) had mild inflammation compared to 4.8% participants who are non-denture wearers. 29(53.7%) denture wearers had fair oral hygiene while most 31(73.8%) non-denture wearers had excellent oral hygiene. Abutment teeth in denture wearers had tooth recession; mostly on the upper arch and also posteriorly. Conclusion: The periodontal inflammation, tooth recession and mobility in denture wearers were worse compared to non-denture wearers. Thus, they need to be motivated for more adequate oral hygiene practices and have regular recall system to monitor their periodontal health.

Measurement of the Clinical Effects of a Marine Fish Extract on Periodontal Healing—A Preliminary Clinical Interventional Study

The aim of the study was to assess the clinical effects of periodontal healing using a Romanian pharmaceutical compound of marine fish extract (Alflutop®). Adults with periodontal disease were included in the study group. Gingival inflammation, the degree of tooth mobility, and probing depth (PD) were recorded for each patient before and after therapy. Patients were divided into two groups: group I—after scaling and root planing (SRP), patients followed therapy with marine fish extract, Alflutop®, group II—SRP therapy alone. Statistically significant differences between groups in terms of gingival inflammation reduction (p = 0.045) were found. Tooth mobility reduction, as well as PD improvement, were also noticed after the therapy (p = 0.001), but no statistically significant differences among PD reduction rates were found (p = 0.356). Alflutop® has proven a certain therapeutic efficiency in the treatment of periodontitis in terms of reduction in the clinical signs of inflammation and tooth mobility.

Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon

Background Techniques to accelerate tooth movement have been a topic of interest in orthodontics over the past decade. As orthodontic treatment time is linked to potential detrimental effects, such as increased decalcification, dental caries, root resorption, and gingival inflammation, the possibility of reducing treatment time in orthodontics may provide multiple benefits to the patient. Another reason for the surge in interest in accelerated tooth movement has been the increased interest in adult orthodontics. Review This review summarizes the different methods for surgical acceleration of orthodontic tooth movement. It also describes the advantages and limitations of these techniques, including guidance for future investigations. Conclusions Optimization of the described techniques is still required, but some of the techniques appear to offer the potential for accelerating orthodontic tooth movement and improving outcomes in well-selected cases.

Gingival overgrowth and associated factors in a population of Nigerian hypertensives

Background: Gingival overgrowth may be idiopathic or secondary. Drug Induced Gingival Overgrowth (DIGO) occurs within 3 months of treatment and is more prevalent in younger age group with predilection for the anterior gingival tissue and usually not associated with attachment loss or tooth mobility unless there is an existing periodontal disease. Methodology: 170 hypertensive patients were recruited for the study; 85 calcium channel blocker (CCB) and 85 non-CCB users. Interviewer-administered questionnaires was used to obtain socio-demographic information as well as medical and drug history. GO was assessed using New Clinical Index for DIGO and data was analyzed with SPSS version 21 (Armonk, NY: IBM Corp). Continuous and nominal variables were described with means, standard deviations and frequencies. Statistical significance was set at P < 0.05. Results: Amlodipine was the most commonly used CCB. The prevalence of DIGO in CCB and non-CCB was the same (49.5%). Gingival enlargement was found equally among both sexes in the CCB and non-CCB groups. A third of the participants with GO were 70 years and above while those without were majorly in the fifth and sixth decade of life. Two-third of those with DIGO had fair oral hygiene status, two-fifth had gingival bleeding and three-fifth had mild gingival inflammation. Those without DIGO in both groups had a slight female predominance and majorly good oral hygiene. Associated factors with DIGO were female sex, 60-69 age group, 10mg drug dosage, been on medication less than 10 years, mild gingival inflammation and generalized gingivitis. Conclusion: There was no difference in the prevalence of DIGO between BBC and non-BBC users. However, there was mild gingival inflammation in all participants with DIGO and amlodipine users were three times more at risk of developing DIGO than nifedipine users. Thus, it is imperative to advise the hypertensives on the importance of maintaining adequate oral hygiene measures and incorporate periodontal care in their management so as to ameliorate the side effects of their medication.

Evaluating the Effect of Attached Gingiva Height on Pre-implant Tissue

Background: Many patients refer to their load implants while there is no attached gingiva in the area of prosthetic implants – unlike the attached gingivae found with natural teeth. The important role played by gingiva in comforting the patient and preventing gingival inflammation has not been fully appreciated yet. This study aimed to evaluate the association between the attached gingival height with gingival inflammation and patients’ comfort. Methods: This retrospective cohort study was conducted to examine 80 implants (Dio uf) placed in 63 patients. At least two months had passed since the patients had had implant crown. The patients were divided into three groups: attached gingiva, gingival up to 2 mm, and at least 2 mm of attached gingiva. Indices such as bleeding on probing (BOP), the amount of plaque, gingival index and patient comfort during brushing and chewing were evaluated. Statistical data were analyzed using the Kolmogorov– Smirnov test, Levene’s test and independent t-test. Results: By increasing the height of attached gingiva, decreases were observed in probing depth (P value=0.004), BOP (P value=0.001), the degree of plaque index (P value=0.006), and gingival index (P value=0.003); and this association was statistically quite significant. By increasing the attached gingiva height, furthermore, the patients felt less discomfort when brushing and chewing; however, the findings were not statistically significant in terms of patients’ comfort during chewing (P value=0.364). Conclusions: Increasing the height of attached gingiva reduced the symptoms of gingival inflammation, but increased patients’ comfort when chewing and brushing.

Diagnostic and Prognostic Markers of Periodontal Disease

Aim of the study: The aim of this study is to determine the values of salivary enzyme biomarkers (alkaline phosphatase – ALP, aspartate aminotransferase – AST and lactate dehydrogenase – LDH) in subjects with healthy and diseased periodontium and to investigate the possibility of using these salivary enzymes as diagnostic and prognostic markers. Methods: We collected saliva with the spitting method from all examinees in the morning, using the recommendations provided by Navazesh. The values of the enzymes in saliva were determined spectro-photometrically, with the following methods: ALP-IFCC, AST-IFCC, LDH-PYRUVATE. IGI Silness-Löe was used to determine the presence of gingival inflammation, and to determine the presence of clinically manifest periodontitis, we determined the clinical loss of periodontal attachment with a graduated periodontal probe. For statistical purposes, we used the method of ANOVA Chi Square and Student’s t-test. Results: The difference in the average salivary AST and LDH values between the first and the second group, as well between the first and third group is statistically significant (p < 0.000). The difference in the average salivary AST and LDH values between the examinees with gingivitis and the examinees with clinically manifest periodontal disease is statistically insignificant (p < 0.485101 for AST, p < 0.816665 for LDH). The difference in the average salivary levels of ALP between the three groups is statistically significant (p < 0.000). Conclusion: The salivary levels of AST, LDH, and ALP can be used as diagnostic markers, while ALP can also be used as a prognostic marker for periodontal disease.

Effects of a Non-Energy-Restricted Ketogenic Diet on Clinical Oral Parameters. An Exploratory Pilot Trial

Ketogenic diets (KDs) may be a helpful complement in the prevention of and therapy for several diseases. Apart from their non-cariogenic properties, it is still unclear how KDs affect oral parameters. The aim of this study was to investigate the influence of a KD on clinical periodontal parameters. Twenty generally healthy volunteers with an average age of 36.6 years underwent a KD for 6 weeks. Their compliance was monitored by measuring their urinary ketones daily and by keeping 7-day food records. Clinical oral parameters included plaque (PI), gingival inflammation (GI), a complete periodontal status (probing depths, bleeding on probing), and general physical and serologic parameters at baseline and after 6 weeks. The results showed a trend towards lower plaque values, but with no significant changes from baseline to the end of the study with regard to the clinical periodontal parameters. However, their body weight and BMI measurements showed a significant decrease. The regression analyses showed that the fat mass and the BMI were significantly positively correlated to periodontal inflammation, while HDL, fiber, and protein intake were negatively correlated to periodontal inflammation. The KD change did not lead to clinical changes in periodontal parameters in healthy participants under continued oral hygiene, but it did lead to a significant weight loss.

RISK FACTORS AND GINGIVAL INFLAMMATION IN CHILDREN AGED 10 TO 14 YEARS - AN EPIDEMIOLOGICAL STUDY

Aim: The aim of the present study is an epidemiological study of risk factors and the prevalence of periodontal disease in children aged 10-14 years. Materials and methods: The subject of the study were 457 children. All were clinically examined, and the data were recorded on a specially designed card. Each child was assessed for risk periodontal profile in 4 levels, which includes: assessment of oral hygiene habits; registration of dental status, reporting of carious lesions and obturations on surfaces dangerous for periodontal health (proximal, cervical); the presence of orthodontic anomalies and other risk factors; assessment of the plaque index of Silness-Loe (PLSL); assessment of gingival index according to Loe and Silness (GILS) Results: Carious lesions at risk for gingival inflammation surfaces are registered in 59% of children, at risk for periodontal health fillings in 32% and orthodontic anomalies in 37%. The studied children showed relatively good oral hygiene (PLSL-0.43 ± 0.28), which improved with age, with the largest amount of plaque observed on the proximal and vestibular surfaces. Over 88% of children have mild gingival inflammation (GILS-0.56 ± 0.42), mainly affecting the front teeth in both jaws. Conclusions: Gingival inflammation in 10-14 year old children covers more than half of the studied children, with mild forms of inflammation predominating with a relatively low oral hygiene index. 2/3 of registered caries and 1/3 of the fillings have a localization which presents a risk for periodontal health. Orthodontic anomalies are the next most serious risk factor for plaque accumulation and gingival inflammation.

Herbal mouthwashes for oral health care-A paradigm shift

Herbs have been used since centuries to prevent and control various diseases. Being low in cost, safe, and easily available, herbal medicines are staging a comeback globally, owing to their antimicrobial, antifungal, anti-inflammatory, and anti-carcinogenic properties. In dentistry, herbal extracts have been widely used in tooth cleaning agents and mouthrinses. The present study is aimed at reviewing various extracts of herbal products and their effects on dental health. From this review study, it is evidenced that Aloe vera, Neem, Clove Oil, Castor Oil, and Peppermint showed better results than conventional mouthwashes in dental plaque and gingival inflammation reductions. However, preclinical and clinical trials are needed to gauge biocompatibility and safety before herbal medicines are often recommended conclusively for oral care.